Policy-taking styles: a typology and an empirical application to anti-Covid policies

Several studies have investigated the variety of governance strategies adopted by European countries to cope with the Covid-19 pandemic. Some nations relied on a more liberal approach, based on recommendations and a lack of mandatory constraints;others trusted more top-down regulations and long-lasting restrictions. The feasibility and success of the different strategies also depend on the way in which policy-takers react. The article uses this exemplary policy case to propose a novel theoretical framework which maps the variety of policy-taking styles applying March and Olsen's (2006) logics of conditionality and appropriateness. Using mobility data, it then employs the new typology to explore the diverse styles adopted by policy-takers reacting to anti-Covid workplace regulations in 29 European countries. The categories proposed can be applied also in different contexts, especially where policy success crucially depends on countless individual behaviours, and policy-makers need to choose the most effective mix of enforcement tools. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

COVID-19 counterfactual evidence. Estimating the effects of school closures

Scholars have started to estimate the effects of non-pharmaceutical interventions to reduce the health impact of COVID-19. However, the empirical evidence is highly contested, and since it is not known exactly what would have happened without those measures, political élites are left free to give credit to the voices that they prefer the most. We argue that any sensible assessment of the effectiveness of anti-COVID policies requires methodological reflection on what is actually comparable, and how to approximate the ideal "method of difference” theorized by John Stuart Mill. By evaluating the effectiveness of school closures as an anti-COVID policy, we provide two examples in which appropriate counterfactuals are inductively discovered rather than selected a priori. In the first one, we use Coarsened Exact Matching (CEM) in a cross-country setting, while in the second one, we implement the Synthetic Control Method in a within-country analysis. The article highlights the methodological advantages of including these techniques in the toolbox of policy scholars, while both examples confirm the effectiveness of school closures. © 2022 Informa UK Limited, trading as Taylor & Francis Group.

Author Correction: Features of fragile people with SARS-CoV-2 infection in isolation in a COVID-19 hotel in Rome, Italy.

Correction to: European Review for Medical and Pharmacological Sciences 2022; 26 (7): 2631-2638-DOI: 10.26355/eurrev_202204_28501-PMID: 35442479, published online on 15 April 2022. After publication, at the request of the Italian Ministry of Health, the authors asked to insert the following statement in the Acknowledgments section: "This research was funded by the Italian Ministry of Health (RC 2022)". There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/28501.

Features of fragile people with SARS-CoV-2 infection in isolation in a COVID-19 hotel in Rome, Italy.

OBJECTIVE: Temporary COVID-19 hotels have been established in Italy to assist the homeless people that test positive for SARS-CoV-2 and require isolation. This observational study aimed to investigate the characteristics of the subjects who were isolated at the Casa tra Noi COVID-19 hotel in Rome between October 2020 and May 2021 and to estimate the duration of SARS-CoV-2 positivity according to their main socio-demographic, behavioural and clinical features. SUBJECTS AND METHODS: Socio-demographic data, clinical history, and anamnestic data of guests were collected by the clinicians reviewing the medical documentation and face-to-face interviewing. Nasopharyngeal swabs were performed every 7 days and the presence of SARS-CoV-2 was assessed by RT-PCR. Median duration of SARS-CoV-2 positivity according to socio-demographic, behavioral factors and clinical condition was calculated. RESULTS: The 196 guests (161 males, 82.1%) had a median age of 41 years (IQR: 30-53), and were mostly African (87, 44.4%). Only asymptomatic/paucisymptomatic infections were observed. Almost half of the individuals (84, 42.9%) were affected by at least one co-morbidity, the frequency of which was higher among women (57.1% vs. 39.8%, p=0.06). The date of the negative SARS-CoV-2 molecular test was known for 144 guests (73.5%). Among these, the median duration of positivity was 21 days (IQR: 14-26) and did not significantly vary with age, country of origin, smoking status, alcohol or drug abuse. Among the co-morbidities, only infectious diseases significantly modified the duration of positivity, which increased from 21 to 34 days (p=0.013). CONCLUSIONS: Hotel guests were frequently affected by physical/mental co-morbidities. Duration of SARS-CoV-2 positivity was significantly prolonged only in individuals affected by an infectious disease.

How agencies are adapting during the COVID-19 pandemic

The impact of COVID-19 has been felt by agencies, big and small, worldwide. The advent of the ongoing pandemic saw many agencies scrambling for new ways of working, as non-essential businesses closed down and workers around the world bunkered down in their homes. While much ink has been spilled on the impact that COVID-19 has had on agencies, little research has been conducted into how agencies are adapting to it. Teams have replaced meeting halls with Zoom calls and water cooler chit-chat with online, socially distanced team-building exercises. This paper explores how agencies have been affected by COVID-19, the implications, and various ways of adapting to the new economic landscape. © 2021, Henry Stewart Publications. All rights reserved.

IMPACT OF THE COVID-19 PANDEMIC ON POSTGRADUATE TRAINING IN RADIATION ONCOLOGY

Purpose: To report the degree to which post-graduate trainees in radiation oncology perceive their education has been impacted by COVID-19. Materials and Methods: A cross-sectional online survey was administered in June 2020 to trainee members of Canadian Association of Radiation Oncology (CARO). The 82-item survey was adapted from a similar survey administered during SARS and included the Stanford Acute Stress Reaction and Ways of Coping Questionnaires. The survey was developed using best practices including expert review and cognitive pre-testing. Frequency statistics are reported. Results: Thirty-four trainees (10 fellows, 24 residents) responded. Nearly half of participants indicated that the overall impact of COVID-19 on training was negative/very negative (n=15;46%) or neutral (n=15;46%) with a small number indicating a positive/very positive (n=3;9%). Majority of trainees agreed/ strongly agreed with the following statements: “I had difficulty concentrating on tasks because of concerns about COVID-19” (n=17;52%), “I had fears about contracting COVID-19” (n=17;52%), “I had fears of family/loved ones contracting COVID-19” (n= 29;88%), “I felt socially isolated from friends and family because of COVID-19” (n=23;70%), “I felt safe from COVID-19 in the hospital during my clinical duties“ (n=15;46%), and “I was concerned that my personal safety was at risk if/when I was redeployed from my planned clinical duties” (n=20;61%). The changes that had a negative/very negative impact on learning included “the impact of limited patient contact” (n=19;58%), “the impact of virtual patient contact” (n=11;33%), and “limitations to travel and networking” (n=31;91%). Most reported reduced teaching from staff (n=22;66%). Two-thirds of trainees (n=22, 67%) reported severe (>50%) reduction in ambulatory clinical activities, 16 (49%) reported a moderate (<50%) reduction in new patient consultations, while virtual follow-ups (n=25: 76%) and in-patient clinical care activities (n=12;36%) increased. Nearly half of respondents reported no impact on contouring (n=16;49%), on-treatment management (n=17;52%) and tumour boards (n=14;42%) with the majority of other respondents reporting a decrease in these activities. Electives were cancelled in province (n=10/20;50%), out-of-province (n=16/20;80%) and internationally (n=15/18;83%). Conclusions: Significant changes to radiation oncology training were wrought by the COVID-19 pandemic and roughly half of trainees perceive that these changes had a negative impact on their training. Safety concerns for self and family were significant and strategies to mitigate these concerns should be a priority.

ILLUMINATING THE GAP: DEFINING CHILDCARE NEEDS FOR CANCER PATIENTS AND THEIR FAMILIES

Purpose: One in two Canadians will be diagnosed with cancer in their lifetime. With a growing proportion of patients under the age of 60, it is estimated that upwards of 25% of cancer patients are managing the demands of childbearing and parenting alongside their diagnosis. There is a paucity of research detailing how parents with cancer balance their needs with the needs of their children. This study aims to more completely define the childcare needs and perspectives of cancer patients with dependent children. Materials and Methods: Between December 2020 and February 2021, cancer patients at one major Canadian Cancer Centre, who identified as primary caregiver to at least 1 dependent (<18 years of age) were invited to partake in a survey study. The survey was developed through consultation with a multidisciplinary team and best survey practices, and consisted of 34 closed and open-ended questions designed to assess childcare needs and the experiences of cancer patients with dependent children. Specific questions were also designed to assess the impact of COVID-19 on childcare needs. Eligible participants were identified by a research assistant and presented the opportunity to complete an electronic or paper-based survey. This study was approved by the local Research Ethics Board. Results: As of February 2021, 42 patients had been contacted and 29 had completed the survey in full (69%) Participants were an average age of 44.7 years ± 4.8 years and 97% female (28/29). Twenty-two participants (76%) reported diagnoses of breast cancer. Participants reported caring for two (18/29), one (10/29), or three (1/29) children. The average age of participants' children was 8.4 years, and ranged from 8 months to 18 years. Fourteen participants (48%) indicated having to reschedule appointments due to issues with childcare (nine of 14 rescheduling 1-3 appt.;4/14, 4-6 appt.;one of 14, 10+ appt.). Additionally, 11 participants (38%) reported bringing their child or children to their appointments as a solution for issues with childcare (seven of 11 for 1-3 appt.;three of 11, 4-6 appt.;one of 11, 10+ appt.). Fourteen of 26 respondents (54%) indicated that balancing childcare throughout their cancer journey has had a moderate (eight of 26) or extreme (six of 26) impact on their stress levels. Sixty-one percent (17/28) reported that the COVID-19 Pandemic has impacted their childcare needs and impacted their stress levels moderately (10/17) or extremely (three of 17). Seventy-eight percent (21/27) reported that a flexible childcare service would allow them to more regularly attend their appointments. The preferred delivery of such a program was onsite (hospital or cancer centre) (13/20, 65%), followed by in-home (seven of 20, 35%). Narrative analysis noted themes of increased stress and childcare responsibilities associated with the COVID-19 Pandemic and reduction of childcare resources and support. Conclusions: These preliminary results indicate that childcare issues are broadly impactful for parents battling cancer. The lack of supportive childcare negatively impacts the emotional psychological well-being of patients and their children, as well as impacts system efficiency and treatment compliance. Survey accrual is continuing and complete findings will aid in defining the childcare needs and perspectives of parents with cancer, as well as highlight potential solutions to support these individuals.

The Literacy Demand of Cancer & COVID-19 Consumer Health Information

The Internet is widely used for accessing COVID-19 information and while abundant, it is frequently complex, inconsistent, and contradictory. This “misinfodemic” has repeatedly revealed low health literacy to be an underestimated public health problem. This study evaluated whether this holds true for information about COVID-19 and cancer on commonly visited websites. “Coronavirus and cancer” and “COVID-19 and cancer” were entered in Google Canada and the first 10 results were evaluated for readability, understandability, actionability, accuracy and consistency. Much of the cancer and COVID-19 information online does not meet health literacy best practices and is inaccessible to patients seeking this information. © 2021 The Author(s). Published with license by Taylor & Francis Group, LLC.